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Showing 4351 - 4400‘Unrealistic Optimism’ Poses Ethical Challenges, May Affect Informed Consent Process
Does a patient’s optimistic expectation of reaping a health benefit from participating in phase I and phase II oncology studies, even when he understands that these early trials are not designed to provide direct therapeutic benefit, compromise the informed consent process? And, does that...
At 5 Years, Brachytherapy Shows Quality-of-life Advantages over Radical Prostatectomy for Favorable-risk Prostate Cancer
Five years after treatment for favorable-risk prostate cancer, men who either chose or were randomly assigned to receive brachytherapy reported quality-of-life advantages in urinary and sexual domains and in patient satisfaction compared to men who received radical prostatectomy, according to a...
Cancer Care in the UK: A Conversation with Chris Parker, MD
In the contentious debate over rising health-care spending, the cancer care policies of the British National Health Service (NHS) are often cited by U.S. policymakers as an example of how health-care rationing denies patients life-prolonging treatments based on costs. The ASCO Post recently spoke...
Research in Combining Targeted Agents Faces Numerous Challenges
If the clinical trials endeavor in oncology is falling short of its goals and if targeted agents have not kept their promise, can a new approach to drug development provide a solution? Very possibly, said John Hohneker, MD, Chair of the Workshop Planning Committee for the conference, “Facilitating...
UN Summit to Focus on Noncommunicable Diseases This Month
For the second time since its inception 65 years ago, the United Nations General Assembly is holding a “High-level Meeting” that will focus on health. During the September 19–20 meeting, world leaders will shine a spotlight on the devastation that noncommunicable diseases are causing and have...
A Conversation with Constance M. Chen, MD, MPH
Although incidence data vary widely, breast cancer–related lymphedema may affect as many as 54% of the 2.3 million survivors of breast cancer in the United States. The condition is often disabling and can result in both long-term devastating physical consequences for survivors, including the loss...
Congressional Hearing Highlights Oncology Drug Shortages
Some oncology drugs are in such short supply that the situation is now critical, with almost 200 drugs affected—triple that of 2003. This was the background described by speakers at a July 2011 congressional briefing sponsored by the Association of Community Cancer Centers (ACCC), ASCO, and other...
Genomic Researchers Identify Weak Points in Breast Cancer Cells
A large-scale project in genetic profiling has identified weak points in breast tumor cells that not only represent potentially new “druggable” targets but could lead to an entirely new classification of all cancers. The findings were recently reported in Cancer Discovery, a journal of the American ...
A Conversation with Samuel Silver, MD, PhD
Over the past 2 decades, significant therapeutic advances have led to greater survival rates and quality of life for patients with cancer. During the same period there has been a transformation in the way oncology services are both perceived and delivered. In a recent conversation with The ASCO...
Increased Use of Hospital Services Boosts Oncology Spending
For our ongoing series on the rising costs of cancer care, The ASCO Post spoke with Lee N. Newcomer, MD, Senior Vice President of Oncology for UnitedHealthcare. Dr. Newcomer is responsible for improving cost-effective cancer care at the nation’s largest health insurer. He shed light on areas of...
Keeping a Positive Attitude
I’ve been in alcohol and drug recovery for 20 years, and my wife of nearly 50 years, Arlene, and I have been through a lot together during that time. So 2 years ago, when my doctor told us that I had stage III prostate cancer and a Gleason score of 8, we both looked at him and asked if we could...
SIDEBAR: Expect Questions from Your Patients
Women who have already undergone mastectomy and chemotherapy may question why additional breast cancer treatment is needed. Benjamin D. Smith, MD, of MD Anderson Cancer Center in Houston said that he frequently has patients referred to him who initially express their preference to avoid radiation...
Many Women Treated for High-risk Breast Cancer Do Not Receive Recommended Postmastectomy Radiation Therapy
Despite major studies showing that postmastectomy radiation therapy improves survival for women with high-risk breast cancer and evidence-based guidelines supporting the use of postmastectomy radiotherapy, 45% of these patients do not receive such treatment, according to an analysis of data from...
Treating Cancer in Japan: A Conversation with Kensei Tobinai, MD
In this installment of Oncology Worldwide, internationally regarded lymphoma expert and cancer survivor, Kensei Tobinai, MD, Chief, National Cancer Center Hospital, Tokyo, sheds light on the Japanese oncology experience. Medical Education What was the medical school experience in Japan like? When...
Lifestyle Changes Can Benefit Patients with Cancer
Oncologists may successfully manage their patients with cancer by following treatment guidelines, but they come up short when it comes to prescribing simple measures to enhance their patients’ health, according to Ann Partridge, MD, MPH, of Dana-Farber Cancer Institute, Boston, who spoke on the...
What the Latest Breast Cancer News Means for Patients
Direct your patients to www.cancer.net/breastsymposium to learn about the research highlighted at the 2011 Breast Cancer Symposium in the special online newsletter, Cancer Advances: News for Patients from the 2011 Breast Cancer Symposium. Also, your patients can listen to a podcast of the...
ASCO’s International Clinical Trials Workshop Educates Nascent Researchers on the Inner Workings of Clinical Trials
Pharmaceutical companies are increasingly conducting drug development research outside of the United States, Western Europe, and Japan. Attracted to the perceived lower costs, easier patient recruitment, and market potential, drug developers are now conducting more phase III clinical trials in...
ASCO’s Immediate Past President Helps Build Future of Cancer Research and Care by Supporting Conquer Cancer Foundation
George W. Sledge, Jr, MD, has been treating patients with breast cancer, and pursuing research in the field, for more than 30 years—the last few electrified by a rapid proliferation of knowledge. “We have so much to offer our patients today,” says Dr. Sledge, who serves as Ballve-Lantero Professor...
Developing Targeted-agent Combinations: Business and Regulatory Issues, and Legal Obstacles
The Institute of Medicine’s National Cancer Policy Forum recently convened a public workshop, “Facilitating Collaborations to Develop Combination Investigational Cancer Therapies,” to address the promises and challenges involved in the development of combination oncologic drug therapies. In the...
Oncology Drug Shortage: An Unintended Consequence of the Medicare Modernization Act and Free-market Forces?
Oncology has a drug shortage problem, and the FDA says that it is getting worse. Drug shortages are not a new phenomenon, but over the past few years we have seen a rapidly growing number of shortfalls that are limiting providers’ ability to care for their patients. In 2004, the FDA reported 58...
A Conversation with Monica Morrow, MD, FACS
Over the past 15 years, practice guidelines have become an accepted tool to help physicians optimize patient care by offering informed assessment of the benefits and potential harms associated with various care options. However, a plethora of new guidelines have entered the market, many of which...
We Can Conduct Clinical Trials of Protons
A great deal has been written about proton therapy, with a good deal of heat and only a modest amount of light. I would like to comment on an aspect of the proton vs photon controversy that I believe has not been adequately addressed: Should we run clinical trials that would allow us to prove that...
Palliative Care, Quality of Life, and Cost
More than half of our nation’s patients with cancer are Medicare beneficiaries, making the entitlement program ground zero in the heated debate on health-care spending. Total Medicare expenditures attributable to beneficiaries in their last year of life runs upward of 30%; this statistic serves as...
FDA Approves Brentuximab Vedotin in Two Lymphoma Indications
The antibody-drug conjugate brentuximab vedotin (Adcetris) was granted accelerated approval on August 19 for the treatment of relapsed or refractory Hodgkin lymphoma and systemic anaplastic large cell lymphoma. Brentuximab vedotin is the first new drug to be approved in Hodgkin lymphoma in more...
Giving Women a Fighting Chance When They Have Breast Cancer
I knew there was a chance I could get breast cancer, I just never thought it would really happen to me. I am one of 2.5 million breast cancer survivors living in our country today. Just weeks after getting a clean mammogram and my 41st birthday, I felt a lump in my breast. As a young and otherwise...
SIDEBAR: Expect Questions from Patients and Colleagues
Among the merits of good clinical studies, according to David P. Ryan, MD, of Massachusetts General Hospital Cancer Center and Harvard Medical School, is being able to cite them when a physician sits down with a patient to explain the possible benefits and drawbacks of treatment. Dr. Ryan stressed, ...
‘Hot Chemotherapy’ Generates Heated Debate about Its Use with Cytoreductive Surgery to Manage Peritoneal Metastases
"Hot chemotherapy” has become the common term for hyperthermic intraperitoneal chemotherapy (HIPEC), which together with cytoreductive surgery is being used by some surgeons to treat patients with carcinomatosis from colorectal cancer. While HIPEC is not considered the most important component of...
Oncology Community Faces Complex Challenges in Evolving Policy Arena
As the political environment heats up in advance of the upcoming presidential campaign season, many issues crucial to the oncology community are being placed on the political chopping block as policymakers seek ways to reduce the mounting debt and soaring health-care spending. To help clarify some...
ASCO Issues Policy Statement to Reduce Cancer Care Disparities
Last August, ASCO issued the policy statement, “Opportunities in the Patient Protection and Affordable Care Act to Reduce Cancer Care Disparities” in the Journal of Clinical Oncology.1 The statement builds on ASCO’s policy on disparities in cancer care released in 2009. It calls on both the...
Short-term Androgen Deprivation plus Radiotherapy Improves Outcomes in Intermediate-risk Prostate Cancer
The addition of short-term androgen-deprivation therapy to external-beam radiation therapy improved overall and disease-specific survival in men with nonbulky localized prostate cancer and prostate-specific antigen (PSA) levels up to 20 ng/mL, as reported recently in The New England Journal of...
Can Bayesian Design Streamline Our Sluggish Clinical Trial System?
The randomized controlled clinical trial has long been the gold standard for new cancer drugs to demonstrate worthiness of FDA approval; however, many experts contend that that our method of bringing drugs to the market is plagued by undue costs, long delays, and overregulation. According to Donald ...
Health-care Policy: A Three-act Play
The health of Americans, the economy, the debt crisis, and the action or inaction in Washington are all seriously interrelated. Decades ago, the bank robber Willie Sutton was asked why he robs banks. His famous answer, “Because that’s where the money is,” succinctly describes the approach that...
SIDEBAR: Expert Q and A
D. Neil Hayes, MD, MPH, of the University of North Carolina, Chapel Hill, discusses the role of HPV status in head and neck cancer. Are you convinced human papillomavirus (HPV) positivity is associated with better prognosis? Dr. D. Neil Hayes: The HPV story influences almost everything we do in...
SIDEBAR: Questions and Answers about Adjuvant Imatinib in GIST
"As clinicians, we really need to ask who should receive adjuvant [imatinib], and we have several ways to risk-stratify patients, including tumor characteristics (size, location, mitotic index), mutational analyses, and a recently published nomogram for patient-specific survival,” said William D....
Novel Approaches and Agents Making Headway against Sarcoma
Novel approaches and agents reported at the ASCO 2011 Annual Meeting are improving outcomes in sarcoma, a heterogeneous disease with historically poor outcomes, according to William D. Tap, MD, Section Chief of Sarcoma Oncology at Memorial Sloan-Kettering Cancer Center in New York. Dr. Tap...
Adjuvant Treatment Still Standard in Melanoma, but New Drugs Prolong Life in Metastatic Setting
At the Best of ASCO® Miami meeting, Omid Hamid, MD, The Angeles Clinic and Research Institute (www.theangelesclinic.org), Los Angeles, California, reviewed abstracts that received a great deal of attention at this year’s Annual Meeting—the new treatments for metastatic melanoma. He also described...
SIDEBAR: Can Society Afford Bevacizumab in Ovarian Cancer?
For bevacizumab (Avastin), as for all targeted agents, there is a critical need to identify likely responders as well as patients at risk for serious toxicities, agreed Daniela Matei, MD, of the Indiana University Melvin and Bren Simon Cancer Center, and session moderator Daniel F. Hayes, MD, of...
SIDEBAR: Using Axitinib in Advanced Renal Cell Carcinoma
With a new tyrosine kinase inhibitor joining the armamentarium, the question is how to optimize targeted agents for advanced renal cell carcinoma. The AXIS trial demonstrated strong clinical activity for axitinib, which was superior to second-line sorafenib (Nexavar) and generally appears most...
SIDEBAR: Will East-West Differences Limit Transferability of Clinical Trial Results?
Differences in patients’ tumor characteristics and in surgical practices between eastern and western countries may limit the transferability of clinical trial results in early gastric cancer, according to Dr. Lockhart. One major difference is tumor location. For example, in the Asian CLASSIC...
SIDEBAR: Is G13D KRAS Mutational Status Ready for Prime Time?
Individual oncologists will have to decide for themselves whether the results from the pooled analysis of cetuximab trials regarding G13D KRAS mutational status are ready for clinical application, according to Axel Grothey, MD, of the Mayo Clinic in Rochester, Minnesota. “We still need...
SIDEBAR: Studies Sparked Questions to Breast Cancer Specialists
Based on the MAP.3 findings, should we be using exemestane to prevent breast cancer in high-risk patients? Dr. Harold Burstein: The risk of developing breast cancer was 2.5% in the placebo arm, vs 1% to 1.5% risk with exemestane. Also, the cancers that were avoided were probably ones with good...
Breast Cancer Studies Explore Wide Variety of Prevention and Treatment Strategies, Offering New Insights
At the Best of ASCO® meeting in Miami, Harold Burstein, MD, PhD, Dana-Farber Cancer Institute, Boston, and Carey K. Anders, MD, University of North Carolina at Chapel Hill, presented high-impact breast cancer abstracts that will enable clinicians to optimize their use of radiotherapy and biologics. ...
SIDEBAR: Searching for More Efficacious, Less Toxic Adjuvant Chemotherapy for NSCLC
Accumulating data are helping to better define the risk-benefit profile of various adjuvant chemotherapy regimens for non–small cell lung cancer (NSCLC) and the impact of adding biologic agents to the mix, according to H. Jack West, MD, of the Swedish Cancer Institute in Seattle. In the randomized ...
Tobacco Remains the Dominant Global Risk Factor Underlying Cancer
Despite clear evidence that tobacco causes at least 18 types of cancer, as well as many other diseases, many people all over the world smoke or chew tobacco, or are exposed to secondhand smoke. Although smoking among Americans has declined slowly but steadily over the past 40 years, it remains the...
Fear of the Unknown: Cancer Treatment Can Be Scarier than the Disease Itself
Two years ago, I was feeling fine except for a nagging problem with severe constipation. I believed this was caused by some loperamide I had taken to quell the episodes of diarrhea I experienced following dinner at a local barbecue restaurant. When the symptoms persisted for a couple of months, I...
SIDEBAR: Expect More Answers in the Future
“We are still following patients from the initial cohort,” reported Martin G. Sanda, MD, principal investigator of the study published in JAMA, “Prediction of Erectile Function Following Treatment for Prostate Cancer.” At a median follow-up now of about 6 years, “there is evidence that there might...
Physicians Can Help Patients Set Realistic Expectations for Sexual Functioning after Treatment for Prostate Cancer
Models that can be personalized to predict erectile function of individual patients following treatment for early-stage prostate cancer have been developed and validated in a study involving a total of 2,940 men, and are ready for use in clinical practice, according to Martin G. Sanda, MD, the...
Integrative Medicine Offers Added Value for Patients with Cancer
Addressing a patient’s physical, emotional, and spiritual needs during the cancer journey, integrative medicine combines such time-honored therapies as nutrition, exercise, and meditation alongside allopathic approaches to cancer care, with the ultimate goal of improving survival rates and reducing ...
Expert Point of View: Panitumumab Is Not Beneficial in KRAS Mutations: No Exceptions
Axel Grothey, MD, of the Mayo Clinic, Rochester, Minnesota, found the findings presented by Marc Peeters, MD, PhD,1 at the 2011 European Multidisciplinary Cancer Congress to be of great interest, from both clinical and research perspectives. “We have two discrepant analyses now for G13D. When we...
Panitumumab Is Not Beneficial in KRAS Mutations: No Exceptions
The need to restrict treatment with panitumumab (Vectibix) to metastatic colorectal cancer patients with wild-type (normal) KRAS tumors was upheld in a study presented at the 2011 European Multidisciplinary Cancer Congress (EMCC). The investigation found a consistent lack of benefit for the drug...
